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03/14/2011 MON 15:04 FAX 402 471 4429 UCC SSCRETARY OF STATE ��� Hall <br />� <br />�� <br />20110203 <br />. . <br />2i.i :,�espa:rt�r.:a�f vyd� <br />�E�`i�''E���E <br />rartww�.�e�MabrS ue1r. �n.�_��v' <br />_.._�._. <br />NOTICE OF STATE TAX LIEN <br />QF�IG/NR C..� L�- y: a70 d Sr/ � <br />�,�,� • 99o�y�2�/�`7, � <br />This Notice of State Tax Lien. is issued by the Nebraska Department of <br />Revenue for unpaid taxes pursuant to the revenue laws of the state of <br />Nebraska. Notice is hereby given that Eaxes including penalties and <br />interest, which are shown below, are due from the taxpayer specified <br />below and remain unpaid after demand. These taxes constitute a lien <br />in the county for real and personal property belonging to the taxpayer <br />or hereaftec acauired. <br />11610905 <br />Category <br />Number <br />22 <br />50490021 [�X Register of Deeds �County <br />Lien Type <br />� a 1�p. �" d� s �Original QX Continuation �Corrected HALL <br />SINESS NAME AND LOCATION ADDRESS TAXPAYER NAME AND MAILING ADDRESS <br />. <br />JERRY L& CAROLE L DENTON <br />t or Other Mailing Address <br />205 S CEDAR <br />State <br />Tax Period I Date of <br />2003 I � 2�01/2004 <br />xxx-xx-3010 I xxx-xx-8592 <br />GRAND ISLAND NE 68801 <br />Amount of 7ax Penalty Inte�est Additioas Balance of <br />Assessment Due <br />4,402.00 220.10 442.12 5,064.22 <br />TOTAL � $ 5, 064.22 <br />� �ereoy cemry �na� u�e r,eorasrca uepanmen� or rcevenue nas compuea wim tne revenue iaws or cne scace or neorasKa in cne ae�erminanon or cne <br />amount shown to be due, and the taxpayer has failed to pay the amount due after demand. if this Notice of State'fax Lien is an extension of an <br />effective lien, it se es to continue the riority of the sfate's interest in the affeUed property of the taxpayer. <br />� ' 402 y� 1-�?i $ <br />e ` ,�j � Revenue Agent 3 ' � (' ' �P <br />sign Prepar s Signatu e Tdle Oate Telephone Number <br />here e Revenue Superviso� d� ,/p , jJ <br />Au orized Signature Title Date <br />4-494-1974 Rev.2-2002 Supersedes 4-494-1974 Rev.10�1995 <br />SEE ATTACHMENTS : `� <br />,� <br />�QQ2/QQ7 <br />DENTON CAROLE L. <br />Filed: �3/14/2011 02:41 PM <br />